Today’s Co-Treat with the OT

Today we had another fun day of co-treat sessions. I’ve mentioned our lunch groups previously; today highlights a typical, traditional speech and OT group. Today’s group was comprised of six kindergarten aged students who all receive speech/language, OT and resource. Our group time is 30 minutes. In addition to the speech room, Kat (the OT) and I share a classroom for treatment. This group takes place in a classroom.

Here is a breakdown of how we run a typical group.

1. Students enter and put their schedule books on a designated shelf and proceed to find a poly spot on the floor for a GoNoodle video. Side note- we use poly spots all the time to help students become grounded and mark their space…more on that another time…

2. Students transition to the next area. Today it was to the carpet to read There Was An Old Lady Who Swallowed a Chick. Yes, we did have the Easter dilemma. Sometimes we change the words to Spring Bunny but since all of the students celebrate Easter we went with Easter Bunny.  Sometimes we read at a table, sometimes we read on the carpet. We try to keep a routine with some variability. We want kids to rely on the language and not just the routine. Students take turns feeding the old lady, nicknamed “Granny” by one of students this week. Funny how the kids never get tired of “feeding” the Old Lady and anyone or anything for that matter.

3. We use a transition question to move to the next area for the next activity. Today students had to recall an item  that she ate. Students aren’t allowed to repeat what another student has said so they need to listen to each other. Sounds simple but this can be a challenge for many of our kids. They are learning that this is a group expectation.

4. Today we borrowed a great idea from Katie from playing with words 365 Sequence necklaces! Graphics are courtesy of her site. First we had the students cut all the pictures of the items the Old Lady swallowed, in the correct sequence. As a modification for those students who have trouble cutting, we imported the pictures into Boardmaker and surrounded them with a bold outline, giving children a better visual of where to cut.

chick cut

5. Next the students sequenced the pictures onto a necklace. Targets include: sequencing, fine motor for threading and following directions. Notice the cotton ball to hold the pictures in place on the end of string…feels a little better than a string knot on the back of the neck. chick necklace

6. If we had the time, we could have had the students re-tell the story using their necklaces. Where does 30 minutes go?? Truth be told, we probably started late and went over late so it all works out.

7. Sometimes we have the students fill out a journal sheet to report on what they have done. Sometimes we send home a sheet completed by us so that the parents can ask about the session with their child.  Here you can find  a copy of the sheet completed by us: speech OT group communication. Feel free to copy for your own use or adapted use.

Why do I love co-treating with the OT? Well, first of all she has made me a better therapist. I now consider sensory, motor and regulatory needs in a way that I didn’t when I first started out. (That wasn’t on the grad school syllabus when I was in school). When you have that moment when a student accomplishes an anticipated skill for the first time there’s someone there to share the joy.  When I’m feeling like the well of ideas is dry, Kat is there to fill it up and vice versa. No matter how good we are, we can’t see everything in a session. It’s always nice to have another set of eyes when reflecting on how the session went and what to do for next time. I could go on but I’ll save some more for next time..


Co-Treating with the OT

Today is Thursday, which is one of my favorite days of the work week. It’s the day I co-treat with the OT, my friend and colleague Kat Felkner. We run several types of groups together. We run traditional speech/OT type groups, class meetings and lunch groups.

We start most of our groups with a GoNoodle video. GoNoodle is a fun, web-based library of music and movement videos  We project the videos on a large screen in the classroom and students imitate the movements  As students complete the videos they move up in levels. After 10 levels, the class avatar gets a new feature, very exciting! Almost, any student can participate in some capacity. Some of the favorites with our kids include: LMNOP and Popseeko. And yes, we move with the video too!

Today I will focus on our lunch groups, AKA Kids’ Cafe. These groups tend to be very popular, if I do say so myself.  Kat and I are lucky enough to share a classroom, so we are able to run lunch groups in the treatment space. We also have some highly appealing activities which is strongly recommended, especially if you are going to ask first/second graders to give up recess. Our Wii system is popular and even the boys enjoy Just Dance.  We typically have 1-2 targeted students and then rotate peers models through. We have found it works well to have the same peers come for 3-4 weeks in a row (each group meets one time per week) to get an idea of the chemistry between the students. Everyone who has shown interest and has parent permission will have a chance to come at least once. By the end of the year, there is less rotating and the same kids come most of the time.

During Kid’s Cafe, we have the students eat together for a specific amount of time. All students are required to sit for this time. We have found this to work so kids don’t pass up on eating lunch in a rush to get to the fun activities. Of course, no one is required to eat but they do need to remain at the table. We use a few different activities during this “group” time. Currently the boys have been into knock knock jokes. We have been writing jokes on index cards for the kids and they take turns reading them to each other. We also post some fun facts on the board to spark a little conversation. Did you know a shrimp’s heart is in its head?? Curiously enough, whatever fun fact we post, no matter how obscure, the group also seems to have someone who already knew it. Hmmm. The girls have been asking to listen to music during the group time. That usually presents an opportunity to discuss preferences and dislikes.

Once the group time has ended, students are allowed to choose what they would like to do. We have different areas identified around the room. Each area is labeled with a picture and is marked open or closed.

photo (4)

We have an arts and crafts area, game shelf, toy shelf, kitchen area, movement area (trampoline and scooters) and a video game area.  Sometimes, the kids want to do the same thing every time they come, so like magic we flip the smiley face around on the sign and close that area. I know, sounds cruel, but the kids really honor the signs and are almost always willing to go to another area try something else. As they exercise some flexibility, they sometimes are surprised to find themselves enjoying a new activity. They sometimes discover, somebody else might like the same things they do. Of course we use a visual time to keep track of the play time. When the timer goes off, students clean up and we return them to class.

With all of the demands on classroom teachers for minutes of educational instruction, the lunch group can be an ideal way to service children requiring social/pragmatic language. Typical peers are available, no instruction is missed from class time and no one seems to recognize it as a therapy service. It’s a win, win.

I’ll share more about the other groups we co-treat next week..